[Congressional Record Volume 163, Number 56 (Thursday, March 30, 2017)]
[Senate]
[Pages S2141-S2143]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                VETERANS CHOICE PROGRAM IMPROVEMENT ACT

  Mr. TESTER. Mr. President, I rise today in support of the bipartisan 
Veterans Choice Program Improvement Act. I will start my remarks by 
saying that Chairman Isakson was here earlier, and he had a meeting he 
had to get to. Johnny has been through a tough surgery, and it is good 
to have Johnny back. But the fact of the matter is he supports this 
bill. He is an original cosponsor of this bill. The same could be said 
of Senator Blumenthal, who also had a meeting and wanted to be here, 
once again. We heard from Senator Schatz earlier. This bill truly has 
bipartisan support, not only in the VA Committee but also in this body.
  The reason people support this piece of legislation is because it 
brings much needed reforms to the Choice Program while ensuring that 
veterans can access care in their communities. It is a good bill.
  A few years back, the Choice Program was established with the very 
best of intentions. In my home State of Montana, it is a fact that 
veterans were waiting far too long for an appointment at the VA and 
oftentimes had to drive over 100 miles for the appointment. The Choice 
Program was supposed to allow these veterans to access care closer to 
home. Unfortunately, it has not been working out the way it should, and 
veterans have been inundated with redtape and a government contractor 
that struggles to schedule appointments and pay providers on time. That 
is why we all worked together--Democrats and Republicans and even 
Independents--on this bill to put forth these much needed reforms.
  The Veterans Choice Program Improvement Act cuts redtape so veterans 
can access care more quickly. In fact, I made it clear from the get-go 
that I would not vote to extend the Choice Program until Congress and 
the VA have addressed some of the biggest concerns I have been hearing 
from Montana veterans and community providers.
  Once we get the bill passed, this program reimburses community 
providers more quickly for the care they provide to our veterans. It 
reduces out-of-pocket costs for veterans receiving care through the 
Choice Program. It improves the sharing of medical records between the 
VA and the community providers to better ensure seamless care for 
veterans, whether they are seeing a VA doctor or a doctor in their 
community. It allows the VA to access all the funding initially 
appropriated for this program to ensure that veterans' access to care 
is not disrupted.

  This bill is not going to fix everything, but it is certainly a step 
in the right direction. With this legislation, combined with assurances 
that I have received from VA Montana, VA folks within the State will be 
allowed to schedule appointments for Montana's veterans directly 
instead of going through an inept government contract.
  It is my hope that we can make the Choice Program work the way it was

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intended when we first set it up, with the goal of serving those who 
have served our country.
  I again express my appreciation for taking this bill up on the floor, 
this Veterans Choice Program Improvement Act, and I think it is a prime 
example of how this body needs to work together to solve problems--in 
this case, for our veterans community. We should push this bill out as 
soon as possible.
  I yield the floor to Senator Moran.
  The PRESIDING OFFICER. The Senator from Kansas.
  Mr. MORAN. Mr. President, I appreciate the remarks, as well as the 
working together with the Senator from Montana as we tried to make 
certain that a program that is so valuable to veterans across the 
country--in my case particularly, veterans who live in rural America, 
in Kansas--to make certain that veterans can attain the care they have 
earned and the care they deserve.
  We had a scandal at the VA in which many tragic things happened, and 
Congress came together at that time and passed the Choice Act. What 
that law basically has given our veterans is, if they live more than 40 
miles from a VA facility--in other words, if they live a long distance 
from access to care--they can, at their choice, have that care at home: 
hometown hospital, hometown physician, pharmacy, physical therapy. They 
can see a provider in their hometown.
  In so many instances in Kansas--in fact, I have mentioned this before 
on the Senate floor. The House district I represented as a Congressman 
is larger than the State of Illinois, and there is no VA hospital in 
that congressional district. So veterans not having to travel 2, 3, 4, 
5 hours to Denver or to Wichita or to Amarillo is of such value to our 
veterans, particularly those who have a disability or are aging. What 
we did in the passage of Choice was so useful to so many veterans.
  The other part of that was that if you couldn't get the care you 
needed within 30 days at the VA, you could then attain your care at 
home. Again, with the backlog that was occurring at the VA, the lack of 
providers, this became important to another set of veterans who, 
because of their health condition, couldn't afford to wait that long to 
see a physician, to have surgery.
  This is important legislation. If you are somebody who cares about 
veterans, you need to be in favor of this Choice Act. If you are 
someone who cares about particularly rural or veterans who need timely 
care, you especially ought to be supportive of Choice.
  The challenge we have is that the Choice Act is expiring. It expires 
August 7, and it needs to be extended. There are dollars available in 
the program. Mandatory spending is available to pay for the services to 
a later date.
  As the Senator from Montana indicated, there are a number of 
provisions that haven't worked very well in Choice because of the 
bureaucratic nature of the program, the way the program has been 
established. One of those that are most important is that you have 
veterans on one side who need the care and choose Choice, but you also 
need a willing provider. The local hospital, the local physician needs 
to be willing to provide that care. I have never known a provider who 
was not honored to provide care to a veteran, but the challenge in many 
instances becomes whether that provider, that doctor or hospital gets 
reimbursed, gets paid.
  This legislation has a number of reforms, but in my view, one of the 
most critical and most important is to make the VA the payer, to make 
the VA be the entity that writes out the check to pay the hospital 
bill, to pay the physician for the services provided.
  So this is another reform that improves really on both sides. It 
eliminates some of the bureaucracy that a veteran goes through and the 
number of times a veteran may receive a notice that he or she owes 
money that should be paid by the Choice Program, and it also 
encourages--by paying them--the physician or the hospital to provide 
the service. These are important reforms, important changes in the 
Choice Act that are worthy of our support.
  What is transpiring here are a couple of reforms to the Choice 
Program and its extension to a later date, until the money expires, so 
the Choice Program can continue, and Congress can now take that time to 
determine what we want to do with the Choice Program into the future 
after that point in time. I appreciate the way in which this 
legislation has worked.
  Often I get asked whether there is any hope that Congress can work 
together, that Republicans and Democrats can solve problems. This is an 
example of where that is taking place today, by the care and concern we 
all have for our veterans and the good will that exists by those who 
serve in Congress to make sure that good things happen for our military 
men and women who are now veterans.
  I regret that the chairman of the Veterans' Committee, the Senator 
from Georgia, Mr. Isakson, is unable to be with us, but, as the Senator 
from Montana indicated, he is fully supportive of this legislation. In 
fact, he is an original sponsor of the legislation.
  I add my voice and ask my colleagues to agree to the unanimous 
consent resolution, that this legislation be passed. It will be another 
step in solving problems and caring for those who served our Nation.
  Yesterday, I was at the Arlington National Cemetery--a reminder of 
the debt we owe to so many people. Those are veterans who are now 
deceased. Those are military men and women who have now died. Those who 
are living deserve the care and treatment that our VA can provide and 
the opportunities that our providers in our hometowns can assist in 
providing.
  We want to make sure that good things continue to happen. We want to 
improve the quality of service, get the problems out of the Choice 
Program, and make sure those who are so deserving of quality care 
actually receive it.
  I yield back to the Senator from Montana.
  Mr. TESTER. Mr. President, I would like to thank the good Senator 
from Kansas for his comments and his leadership not only on the VA 
Committee on which we both serve but also as chairman of the 
Appropriations MILCON-VA Subcommittee, the subcommittee that really 
sees how the money is going to be utilized within the VA. I think 
Senator Moran has covered just about all of it. I just want to go back 
and say one thing.
  We are going to have a unanimous consent. I am told there will be an 
objection to it. That is truly unfortunate because this has been a 
bipartisan effort. It has cleared everyone in the Senate except one 
person, to my knowledge, and I think that is unfortunate.
  One of the complaints I hear is that the primary payer provision of 
this bill is the problem. The primary payer provision of this bill 
requires the VA to be exactly that--the primary payer of the bills. My 
question would be, Why is this a bad thing? Right now veterans are 
being hamstrung and delayed, and the folks who provide the benefits, 
the providers, are not getting the dollars in a timely manner. I would 
just ask, if the VA is not going to be the primary payer, who is?
  These folks have put it on the line for this country, and they come 
back in different shape than when they left, after they bore the 
battles of war. Some of the injuries are seen; some of the injuries are 
unseen. And we are not going to say ``You know what. Don't worry about 
it. We are going to make sure you get the care, and we are going to 
make sure it is paid for''? It is part of the cost of war. So when we 
send our young men and women off to war, we ought to be thinking about 
this stuff. And we have a solution. We have a solution to part of the 
problems with the Choice Program.
  If we get this bill passed, it will give us the opportunity to work 
together to get a long-term bill passed before the first of the year to 
really address the needs of our veterans so that there are wraparound 
services at the VA that veterans can count on.
  I would just say that this is supposed to be a very deliberative 
body, and for the most part, it is pretty deliberative. But when you 
have a situation of a program that we put into effect--that Congress 
passed and the Senate had a big part of writing--and it is not working, 
we ought to fix it, and this bill fixes it in good part. We have some 
more to do, as I said, but this bill is a step in the right direction 
in cutting redtape and making it easier for veterans to find care and 
get care, whether it is in the VA or outside the VA. It

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is also something that the Veterans Administration sorely needs to move 
it forward.
  I just want to say that we come in here and we have good arguments 
and good discussions, and sometimes politics comes into the discussion. 
In this particular case, folks have come to the table--whether it is 
Senator Isakson or Senator McCain or Senator Moran or me or any of the 
others on the Veterans' Affairs Committee--and we have come up with a 
solution that 99 percent of the people in this body agree with, but we 
can't get it across the finish line. And we wonder why our popularity 
is in the single digits in this country.
  I am just going to close by saying I want to thank everybody from 
both sides of the aisle who worked together to get this bill crafted 
and get this bill to this point. I hope that at some point in time, 
people will take a look at this bill for what it does and realize that 
there aren't bogeymen in this bill, that our veterans deserve us to 
work together to find solutions to move the ball forward so they can 
get the healthcare they were promised when they signed on the dotted 
line to protect this country.
  The PRESIDING OFFICER. The Senator from Kansas.
  Mr. MORAN. Mr. President, it is my understanding that one of my 
colleagues is en route to speak and perhaps object to this motion that 
is to be made. I would ask my colleague from Montana if he would mind 
holding for a few moments until that Senator arrives.
  Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. TESTER. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. TESTER. Mr. President, I was going to ask for unanimous consent 
that S. 544, the bill we have been talking about, be discharged for 
immediate consideration, and then someone would have to object to that 
unanimous consent request--otherwise it would move forward.
  I am going to do this on Monday. I hope the Senator who is truly 
going to object to this will have the opportunity to talk to Secretary 
Shulkin and Chairman Isakson, and he will find out that both those 
people are in support of this bill.
  Hopefully we can come in and do a unanimous consent and get this bill 
passed on Monday. This is a bill that is good for America's veterans. I 
think it is good for our community providers, and I think it is very 
good for the VA. We will hold off today and take care of this after the 
weekend.
  I would like to once again thank all the folks who worked on this 
bill. A special thank-you to Senator Moran for his statements today.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The senior assistant legislative clerk proceeded to call the roll.
  Mr. CARPER. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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